Activity Basics 1 Week 4 of 4 CALGARY FOOTHILLS 1 Agenda - - PDF document

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Activity Basics

Week 4 of 4

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Agenda

• Homework review
• Ergonomics at home and at work
• Pacing
• Take Home Points

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Group Discussion: Homework Review

• Self-Monitoring

– Neutral spine and posture – Monitoring body mechanics - challenges and successes?

• Activity Analysis exercise

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Ergonomics

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Neutral Spine and Body Mechanics Review

Minimize twisting Minimize reaching Maximize strength Conserve energy Goal: Reduce likelihood for excess strain or repetitive stress

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Basic Ergonomics

• Ergonomics is the fit between the person and their physical

environment when completing a task

• Awareness of our environment, or 'workspace' for any

given activity

• Optimal ergonomics promote safe and efficient body

mechanics

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Task Setup

• Using hands directly in front of, and close to body
• Light weight activities requiring precision are best done

between elbow and under arm level

• Light to medium weight activities are best done at

approximately elbow level

• Heavy activities are best performed between elbow and hip

level

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Group Discussion:

• How are you sitting right now?
• What is your workstation set up right now?
• Are you feeling any excess muscle strain or tension

right now?

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Workstation Ergonomics

• When working at a desk or counter

– Relax your shoulders – Keep your upper arms close to your torso, and elbows bent to approximately 90 degrees – Position your wrist in a straight line with your forearm and fingers – Objects that you reach for frequently need to be closest to your body – Adjust your chair height and use a foot stool if necessary to have your knees level with your hips

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Workstation Ergonomics Continued

• Remember head posture

– Position computer monitors or car mirrors so the chin can remain tucked and head neutral – Consider what part of your glasses you look out of, and pay attention to whether you are lifting your chin (e.g. you may need to lower a monitor if wearing bifocals) – Consider the distance required for visual acuity, and notice if you are poking your chin forward to see

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Sitting Position

• Sit in a chair with your:
• Knees approximately

level with your hips

• Feet flat on floor or

stool, directly under your knees

• Weight on bum cheeks

(sit bones)

• Spine ‘tall’
• Chin tucked
• Use a lumbar support to

maintain the natural curve in your low back

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Lying Position

• Lying down

– Thinner pillow under the head for back lying, thicker for side lying – Ears over shoulders over hips – Pillow lengthwise from knees to heels for back lying or between lower legs for side lying – Do not bend hips or elbows more than 90 degrees – Pillow in front of torso to support upper arm in side lying – Hands below shoulder level

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Pacing

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The Tortoise & The Hare

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The Pacing Approach

“Active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities” (Jamieson-Lega, Berry & Brown, 2013, p.207)

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Rest and Recovery

What is the purpose/intention? Passive, unstructured OR Active, winding down of nervous system following activity

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How to Pace?

We've already discussed: – Changing position (Posture, Positioning, Body Mechanics) – Modifying the activity (Activity Analysis, Body Mechanics, Ergonomics) We will now add: – Incorporating self-care or leisure activities – Alternating between activities – Planning brief rest periods – Mindset

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4 P’s of Pacing

Positioning Prioritizing Planning Perspective

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Positioning

(How are you going to do it?)

• Pay attention to having neutral spinal posture, good body

mechanics and ergonomics during activities

• Alternate activities so that you are using different body parts
• Use assistive devices to decrease strain on your joints and

muscles (e.g., long handled devices, foot on stool in standing position, grab bars, walking poles)

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Prioritizing

(What do you need to do?)

• Prioritizing activities
• Things you have to do, are expected to do and want to do
• Putting them in order of importance
• Identifying any you can share or give away
• Recognize that thoughts and emotions demand energy too

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Planning

(When are you doing to do it?)

• Choosing a period of time you feel comfortable to plan

ahead for

• Today, a few days, a week
• Create a flexible and balanced schedule to budget

your energy output

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Planning

• How to Plan:
• Use a calendar/daytime/organizer
• Schedule the priority activities based on tolerances
• Alternate more and less demanding activities
• Schedule them so that no one day is more demanding than

the next

• Include rest and self-care throughout your day

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Perspective

(Why are you going to do it?)

• Remind yourself that by pacing you will get your most

important tasks done within your tolerance levels

• Pacing is hard work, and it takes time to get it right
• Pacing becomes more automatic with time
• Having difficult/unwanted thoughts and feelings is

normal

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What Happens on a Bad Day?

• On a bad day, you are still within your normal range of pain (you are not in a

flare-up), so do what you have planned

• Remind yourself that you will take a break if your pain or fatigue increases by 1-

2 points out of 10 or if you feel that continuing will result in a delayed increase in pain or fatigue

• Do not abandon the schedule entirely – remember, our bodies need to move –

modify, ask for help with, or eliminate the most demanding tasks

• Schedule more breaks and coping strategies – use your self-management plan

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What Happens during a Flare-Up?

• Flare up plan is individualized to you
• May need to modify activities or schedule
• Regular use of self-management strategies
• Helpful to contact your health care provider for individualized

support

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If I Feel Good, Can I Do More?

• Pacing your activities allows your body to adjust to a more

consistent energy output, with fewer peaks and valleys in pain and energy

• On a good day, do not add a challenging activity, enjoy having

less pain or more energy and only add low demanding, enjoyable tasks

• Then you will be more likely to have another good day

tomorrow

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Group Discussion: What stands out for you?

• Explain Pain
• Rest and Activity
• Self-monitoring
• Increasing Tolerances
• Posture
• Activity Analysis
• Body Mechanics
• Exercises: Stretching and Strengthening
• Ergonomics
• Pacing

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Self-Management Plan

Please add any self-management strategies you have found helpful from class to your self-management toolbox

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Next Steps

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